Affordable Care Act tagged posts

The Clock Is Ticking on the 7 Million Uninsured with Behavioral Health Conditions

Ron Manderscheid

Ron Manderscheid, PhD
Executive Director
National Association of County Behavioral Health & Developmental Disability Directors

Now is the time to help the 7 million uninsured Americans with behavioral health conditions understand their health coverage.

In a recent post, Hannah Sentenac discussed the challenges young adults face accessing mental healthcare. Because many Millennials are choosing job flexibility and self-employment over traditional employment, they are faced with the costly prospect of purchasing their own health insurance; and many have simply chosen to go without. Even for Millennials who have insurance (either employer-sponsored or self-purchased), high co-pays and hefty out-of-network charges have prevented many from obtaining mental health treatment, she states.

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What Does 2014 Have in Store for Mental Health Funding and Access?

ChuckIngogliaCharles Ingoglia
Senior Vice President, Public Policy, National Council for Behavioral Health

Now that we’re a couple of weeks into January, 2014 is shaping up to be another important year for mental health policy. In today’s CFYM post, Charles Ingoglia, MSW, Senior Vice President, Public Policy, National Council for Behavioral Healthcare shares why he is optimistic about advancement of mental health policy issues in 2014.

Last week, we asked for your input about the most pressing mental health issues for the year ahead. So, there’s certainly plenty to talk about. Share your thoughts on whether or not you are optimistic about mental health advancements or if you think there is still much work to be done by commenting in today’s post.

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Care for Your Mind’s 2013 Best Of List: Mental Health Policy Advancements

It’s that time of year again when the “Best Lists” come out. The mission at CFYM is to facilitate discussion by sharing the views of experts in the community. In that spirit, we are summarizing the “Ten Best” list from the National Institute of Mental Health to create our own “Five Best List.” We want to hear from you. Read the post and tell us what you believe are the best advances in policy and advocacy during 2013.

Mental Health Advocacy Begins with Science

Director Thomas Insel of the National Institute of Mental Health makes the argument that science leads to better policy. We are encouraged that scientific advances shift the conversation towards more self-directed treatment plans. It is the empowerment of treatment ownership that fosters advocacy and ultimately leads to a life of thriving, not just surviving.  We’ve compiled our top five list below, with the corresponding NIMH rank in parenthesis.

5. (10 on the NIMH List):  “Nobel Prize—This year’s Nobel Prize in Physiology or Medicine (and Lasker Award) recognized NIMH grantee Thomas Südhof for his discoveries of how neurotransmitters are released from the pre-synaptic terminal.”

This research includes better understanding on how neurons in the brain communicate. We don’t know where the research will lead, but better knowledge about how molecules translate bio-chemical messages, give us reason to hope for advances in treatment options.

4. (9 on the NIMH List): “Beyond Magic Bullets—Several important new trends emerged this year in non-pharmacological treatments, sometimes from pharmaceutical companies. In April, a Nature commentary that included authors from the pharmaceutical giant GSK described “electroceuticals,” heralding a new era in treatment development focusing on devices to deliver electric signals rather than drugs to alter the activity of neurotransmitters in the brain.”

Many peers have reported successful outcomes with this type treatment. We are encouraged that pharmaceuticals are exploring options outside of strict pharmacology protocols.

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Final Parity Ruling and Obamacare

healthinsurance2Cause for celebration or just one victory in a long-term battle

On November 8, 2013 the Obama administration released the final rule providing guidance on how health insurance plans should implement mental health parity. In short, the rule states that mental health coverage must be equitable to how insurance plans cover other physical conditions. Restrictions accessing care and reimbursement for services can no longer be different for mental health in relation to other health care services. Additionally the ACA, more popularly known as Obamacare, requires that mental health coverage be included as an essential health benefit for plans available through the market exchange.  In short, as of January 1, 2014 private, marketplace exchange and Medicaid Expansion plans must offer mental health care and it must be with parity.

Much has been written about the ruling. Most of it positive. Bloomberg BNA states advocates are praising the rule. The National Council applauds the ruling saying it is “a huge victory for people living with mental health needs and for the nation as a whole.

CFYM has covered the topic in past blogs and has provided instructions on how to fight for your coverage rights by challenging an insurance claim denial. Carol McDaid of the Parity Implementation Coalition posted on September 19 that now is the time to become an informed, empowered, and vocal consumer. There is much work still to be done to ensure the civil rights and protection of people living with a mental health condition when it comes to access, however.

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Will Your New Insurance Plan Do a Better Job Covering Your Mental Health Care?

Gretchen is optimistic that hers will.

The federal government is in shutdown mode but the health insurance marketplaces are open for business. People with mood disorders and their families have the opportunity to explore the pros and cons of different insurance plans that become effective in January 2014. Mental health care must be covered, but will the different levels of plans pay for the services you need? What will you need to pay for yourself?

Gretchen, who lives with a mental health condition, is hopeful that her new insurance will cover her preferred therapist and psychiatrist...

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Participate in Largest Expansion of Mental Health Coverage in a Generation

healthinsurance2The government may not be open for business, but the market exchanges and 24 hour phone lines are operating today!

Marking today’s opening of the health exchanges, Care for Your Mind shares information and resources about who has to have insurance, what’s involved in enrollment, and what we know about mental health care coverage.

Millions more will now have access to mental health care

If you’re looking for health insurance, you have some new options! Today the health exchanges are open for business. That’s because today is the first day of the enrollment period for the health exchanges established under the Affordable Care Act (ACA) to enable the purchase of health insurance.

Here we are providing links to information covering the individual mandate, enrollment in a health exchange, and what is currently known about mental health coverage. Do you know how the ACA is changing health care?

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Are You Getting All the Mental Health Coverage You Deserve?

CarolMcDaidCarol McDaid
Winning strategies for filing a mental health insurance coverage grievance

CFYM Note: This is the last in the series by Carol McDaid on your rights with regards to mental health insurance parity laws and expanded coverage under the Affordable Care Act. Tuesday’s post provided an overview of what types of denials to look out for. Today, Ms. McDaid tells readers how to file a grievance for denial of mental health insurance coverage.

When should I file an appeal

Mental Health America compiled this list of questions to help you understand if you should appeal a coverage denial. At first glance, the questions may seem to require a sophisticated understanding of your plan and the law, but you can simplify it this way: If the answer is YES to any of the following questions, the plan is most likely not in compliance with the new laws.

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What Can You Do If Your Mental Health Benefits Are Denied?

Carol McDaid
Carol McDaid
Parity Implementation Coalition

Follow these practical steps to win your appeal.

CFYM Note: Last week, Carol McDaid answered the question, “Doesn’t health insurance have to cover mental health care?” She also described steps to make sure you’re getting all the health care benefits you should. This week, Ms. McDaid covers what the mental health parity law means for you when you don’t get the benefits you’re entitled to.

From promise to reality

The fact that we now have two federal laws requiring mental health parity is cause for celebration—both for those of us who spent years advocating for the laws and those of us, me included, who have been denied coverage by our insurance plans.

The Mental Health Parity and Addiction Equity Act was signed into law in 2008. The Affordable Care Act goes into effect January 1, 2014, and will require more plans, including those in the newly created health insurance exchanges, to offer mental health parity. (Read more about the laws in Part 1 of this series.)

The federal laws are on top of state laws that exist in approximately 40 states to protect people from being denied mental health benefits through public and/or private employer-sponsored health insurance. (View a chart of state mental health parity laws from the National Alliance on Mental Illness.)

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